Subject: Community Medicine

Topic: Course Development Program

Lecturer: Dr. Paredes
Date: February 9, 2016

OUTLINE factors/ causes of presenting health problems

I. Overview VI. Designing the Curriculum In the process, help them realize
II. The Physician as an Educator VII. Course Program o What they are capable of
III. As Trainers of the CHW VIII. Lesson Plan o How they can develop and institute changes – small & big ones
IV. Community Based Health IX. Summary
o How to implement changes
Program
V. Roles of CHW (Phil. Settings) o Value and practice self-reliance in health
OBJECTIVES
At the end of the lecture, given the Primary Health Care (PHC) roles/tasks of a III. AS TRAINERS OF THE CHW
CHW, the student should be able to: You need to know:
1. Formulate appropriate teaching-learning objectives o CHW roles / tasks in PHC
2. List down the topics and content pertinent to a PHC teaching-learning o How to develop a plan for training of CHWs
module
3. Identify learning/teaching strategies suitable for adult learners on a
given topic
This is part of the medical student’s job as future teachers of the
4. Prepare appropriate resources that will enhance and facilitate learning CHWs.
5. Develop non-threatening assessment tools for student learning As teachers/trainers, design a curriculum for training CHWs in PHC:
6. Write a lesson plan for a given topic o Identify CHW roles
o Analyse tasks/subtasks pertinent to the roles
References: 2016B Trans, PPT, Recording o Task analysis
o Course program
Legend:
o Lesson plan
o Deliver the teaching/ learning session
I. OVERVIEW
o Evaluate
A. The 5-Star Physician
1. Health Care Provider
A. CHW Training Plan
2. Teacher
1. Identify CHW ROLES
3. Social Mobilizer
2. What are the TASKS PERTINENT to the roles
4. Manger
3. What are the KAS (knowledge, attitude, skills) they need to
5. Researcher
develop
4. Design a training CURRICULUM
B. Program Plan
5. IMPLEMENT this
Poor health situation based on survey or given data
Develop a PROGRAM PLAN that provides solution to the problem IV. COMMUNITY BASED HEALTH PROGRAM
Your Roles:
C. Community Based Type of Program 1. Organizer – Social Mobilizer
Community Based Health Program – participatory, self-reliant 2. Teacher/ Trainer – Facilitate PHC training of community health
SHOULD include local human resource teachings among others workers
According to the lecturer, this is the type of program that we 3. Role Model for providing primary level care
should develop. It a partnership program between you, the
organizers, teachers and members of the community. V. ROLES OF CHW (PHIL SETTINGS)
People should be empowered Provider of health care
Home-based/primary care and treatment
D. Job – Task Identification Provide psychosocial support for patients under treatment
Roles of CHW – health care provider, educator and organizer Accompany patients through their illness, help develop trust and
Identify tasks related to the roles, analyze tasks confidence
Link between patient and health center
E. Prepare Training Curriculum Case finding, recognize s/s, encourage screening
Grouping of related tasks, figure out best way to teach/learn, Health educator
evaluate learnings for prescribed tasks – COURSE PROGRAM Factors related to disease development
Preparations for each of the lessons Disease transmission
How to prevent illness
II. THE PHYSICIAN AS AN EDUCATOR Health living/lifestyles and habits
A. Tasks: Teaching CHWs Leader-organizer-social mobilizer
1. Design a curriculum for training of CHWs in primary health care You cannot move a program by just yourselves. You have to
2. Enable CHWs to perform tasks related to their roles in primary organize people to participate in the program.
health care or in a CBHP
A. Washington State Dept. of Health
B. Possible Responses
CHW provide services like:
Build partnership towards better health for the community o Health education
Together with community folks and especially the CHWs identify

Trans Group: Tin, Joseph, Kelly, Aly Page 1 of 4

Edited By:
 o Informal counseling Provide ample time for each of the activities and logical breaks
o Social support Formulate a course program. This serves as a training outline and
o Care coordination provides mechanism for proper review
o Health services enrolment and navigation
o Ensure preventive health screening VII. COURSE PROGRAM
o Outreach Equivalent to an architect’s perspective or floor plan
o Advocate A general training outline that takes into consideration the
proper sequencing of the topics
As Teachers/Facilitators, we need to be certain that the CHW Provides structure and tailors the training contents with
trainees: methods of imparting and assessment
o Acquire Knowledge and Skills Serves as mechanism for review of the training course and its
o Develop the right attitude implementation
o Convert the KAS into right behavior and practices Course program parts:
o THUS: NEED for them to undergo FORMAL TRINING COURSES o Time / Duration
o Main Topic
Must-know is given to CHW, in contrast to medical students who o GENERAL Learning Objective for a particular topic
need to know the must-know, nice-to-know and useful-to-know o Teaching / Learning Strategies
To teach them effectively, we must understand the knowledge o Teaching / Learning Materials
and skills required to perform the tasks assigned to them o Method of Assessment – ex. Role Playing, Checklist, Discussion

Community Health Workers Table 1.Example of a Course Program

Need to acquire certain knowledge and skills TIME MAIN LEARNING TEACHING TEACHING ASESSMENT
Need to develop the right attitude (duration TOPIC OBJECTIVES STRATEGIES MATERIALS METHODS
THUS, a NEED for them to undergo a FORMAL TRAINING COURSE of the (GENERAL)
to acquire all these module)
Must-knowis given to CHW, in contrast to medical students who
need to know the must-know, nice-to-know and useful-to-know
To teach them effectively, we must understand the knowledge
and skills required to perform the tasks assigned to them 9 Steps in Formulating a Course Program
1. Review the CHW ROLE and the tasks related to the role.
Organizers of Training Courses for CHW’s 2. Do a task analysis – identify all the necessary subtasks
DOH Philippines (knowledge, skills & attitude related to a task that the CHW need
NGOs e.g. CHD –e.g. Council for Health Development to learn).
USA based training courses TIP:concentrate on MUST KNOWs
India 3. For every task & subtasks, identify the topics or the contents
Uganda that need to be learned.
China – This is where the first model originated. Their village 4. Develop the teaching/learning objectives for the session or unit.
health care workers are called the barefoot doctors. From there, – justthe general objectives
we develop the idea of our own CHW.2 5. Arrange the topics in a systematic order or sequence and
Others worldwide appropriate ample time.
6. Select an appropriate method of imparting, either through
classroom, practical or both activities that will facilitate the
VI. DESIGNING THE CURRICULUM
learning process.
Developing a plan for a teaching/learning module
– teaching strategy (adult learners)
Integrating the identified contents, teaching strategies/methods, 7. List down and create the learning resources.
teaching aids and other training resources into a curriculum
8. Develop the assessment method appropriate for the
Designing the teaching/learning process in ways that enhance teaching/learning session. – making a checklist during the
learning and promote retention so they will develop the teaching process can also be used as an assessment tool2
appropriate skills Decide on the time duration for the whole unit and its parts including
the proper timing of logical breaks
Priniciples In Curriculum
Organize the topics, contents and methods into logical units or EXAMPLE Course: Tuberculosis Control & Prevention – TASK
sessions – you have to put the tasks and subtasks together to ANALYSIS
come up with a particular content/topic. We also have to think of Role of CHW: Provider of care for patients with tuberculosis
appropriate methods that would jive with the teaching of the TASK 1: Recognize patients with tuberculosis (Module: TB
contents. Then divide all the contents into a logical order and its Diagnosis)
proper sequence. This will be the divisions of the
2 o Subtasks
teaching/learning sessions.  Obtain history & other pertinent information, carefully
Link the appropriate units to provide continuity – the CHW’s must considering patient’s sensitivities – K S A
need to know first the problem, how big it is, and what can they  Prepare patient for PE, providing enough privacy and
do to solve the problem respect – S A
Allot appropriate time limits for an entire unit

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  Identify hallmarks of TB from history and PE – K DAY 4 Role of Enumerate DOTS Handouts, Role
 Carefully collect early morning sputum samples and TB tx & explain clinic checklist, playing
submit for microscopy – S A 4 hours partners tasks & observa- recording
responsi- tion, forms
 Explain history, PE, laboratory findings to patients and
bilities of evocative
family members with care – K S A tx partners discussion

TASK 2: Ensure proper treatment of TB patients through DOTS

LEARNING OBJECTIVES
o Subtasks
GENERAL OBJECTIVES
 Accompany TB suspect for enrolment to a DOTS clinic
o Refers to the competency or the observable behavior
 Explain to patient the importance of adequate treatment:
expected to be developed or performed BY THE LEARNER at
drug dosages, duration, follow-up period and role of
the end of the unit or session.
treatment partner
SPECIFIC OBJECTIVES
 Explain to patient and family the ways of preventing
o Must be measurable
spread of TB
o Sets a minimum level of performance
 On daily basis, observe and record the patient’s intake of
o Time-bound
prescribed anti-TB drugs
The subtasks serve as the learning objectives for the course
program. Convert the subtask into specific objective.
TASK 3: Conduct TB education and case finding campaign
o Subtasks Please refer to previous table for an example of learning
 Develop a plan/organize a “TB education and case finding” objectives
drive
 Explain to participants the following: LEARNING / TEACHING METHODS
The state of TB problem in the community The teaching/learning strategy that enhances retention, fosters
The manifestations of TB, hallmarks, etc cooperative learning
Spread or transmission of TB Promotes self-directed learning
DOTS clinic accessibility, importance of adequate Provides immediate feedback and positive reinforcement
treatment, follow-up and highlighting the role of Provides opportunity to apply learning
treatment partner “STUDENT CENTERED ACTIVITIES Vs Teacher centered ones”
Recommended methods
EXAMPLE Course: Tuberculosis Control & Prevention – COURSE o Evocative discussions, sharing experiences, brain storming
PROGRAM PARTS & CONTENTS o Group work, case studies, worksheets
o Simulation, role playing
TIME TOPICS/ LEARNING TEACHING TEACHING ASSESSMENT o Demonstration-return demonstration with checklist, paired
(Duration CONTENTS OBJECTIVES STRATEGIES MATERIALS METHODS practice
of (general classroom/ o Games, observed or supervised field work
module) objectives) practical
o Wet clinics, etc
DAY 1 TB 1. Discuss Evocative Flip chart, Short
problem magnitude discussion local stats answer o Minimize use of LECTURES!!
2 hours of TB in questions
com- by groups Example: Learning Methods
munity At the end of the 2nd session, the METHODS:
2. Explain Puppet Puppets & Games, trainee shall be able to:
charac. of show, props, flashcard 1. Recognize the manifestations Evocative discussion
bacilli & evocative flashcards, assembly
of TB from a complete medical Skit
modes of discussion handouts,
spread comics
history of a patient suspected to Actual DOTS clinic observation
DAY 2 S/sx of Identify Skit – TB Script, Checklist have TB
TB s/sx, suspect at actors, 2. Explain the importance of Small group discussion
4 hours hallmarks clinic; flashcards, sputum examination in the
of TB from DOTS handouts diagnosis of TB
history & clinic 3. Discuss TB treatment and Role playing
PE obser- partners as recommended in the
vation
DOTS clinics
DAY 3 Tx of TB 1. List Evocative Flip chart, Short
– DOTS down discussion actual TB answer Explain ways of preventing Evocative discussion
2 hours DOTS meds, questions further spread of disease Small group discussion
clinic Demo handbook, by groups,
prescribed recording workbook TEACHING RESOURCES/AIDS
TB drugs forms exercises Handouts
2 hours 2. Explain Story- Flash Games:
Flipcharts
imptance telling, cards – flashcard
of tx evocative key assembly Comics, drawings
compliance discussion messages, Checklist, flowcharts
comics Models, actual materials
Use things that the community can relate to, such as telenovela
*if possible, use indigenous materials

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 DURATION OF LEARNING UNITS
After arranging topics/contents in proper sequence (logical order;
basic or pre-requisite to complex; job performance order), allocate
appropriate time for each unit & corresponding parts
Pace sessions accordingly, proper timing of breaks, insertion of
activities that reinforce learning
ASSESSMENT METHODS
The objective of assessment method is for us to be able to identify the
CHW who needs to be taught more thoroughly
Checklist
Games
Role play exercises
Return demonstration
Project work
Rating scales
Short answer questions
VIII. LESSON PLAN
A. Steps: Lesson Plan
1. Define the objectives (general & specific) of the session.
2. Plan the introduction – “bridging” if related to previous lesson.
Relate this to the goal & relevance of the lesson to the CHW role.
3. Choose CONTENTS that must be known by trainees
4. Plan the learning strategies – suitable for the topic, use resources
that enhance learning. Appropriate pacing & division of activities.
5. Plan the summary & follow up
6. Plan the assessment – assessment is done from time to time, while
evaluation is more on the “overall” teaching process
CONTENTS
Do not CRAM too much information, concentrate on “must know”
Be innovative in strategies & setting
Be generous in the use teaching aids/resources
Know the students’ level of KS
Refer to course program
B. Assessment
As stated before, the objective of the assessment is to determine
who is to be given more time for learning 2
Give exercises back to trainees
Use checklist & rating scale during practicum, demo-return demo
Games as form of assessment
Role playing as learning strategy as well as an assessment tool
Objective of assessment is to identify strengths, weaknesses and
misconceptions SO THESE CAN BE CORRECTED!!
C. Parts of a Lesson Plan
General objective/s of the unit, specific session
Specific objectives – competencies that the students shall be able
to demonstrate at the end of the session
Introduction – outline form
Main contents: Outline of the topics covered. List down Key
Messages up to the summary.
Teaching methods: classroom & practical and the duration of
each activity
List of teaching resources
Assessment tool
D. Educational Process
IX. SUMMARY
Planning the whole learning/teaching process:
Curriculum design
Organizing the topics, contents in proper sequence & time, using
resources to enhance learning process
Developing assessment methods & tools that promote trust and
confidence
Lesson plan serves as THE GUIDE in delivering to the trainees
what they need to learn as primary health care workers in a
teaching/learning session
“Teaching for better learning” - Fred Abbatt
KEY MESSAGE
The roles and tasks of the trainee serve as basis for learning
Organize the learning process through: curriculum design and the
course program
Be guided during each session with the lesson plan
Reminder: CONTENTS OF THE MESSAGE
I. Program plan
II. Roles and the list of tasks.
III. Task Analysis
IV. A course program for training the CHWs (in preparation for their
role in the CBHP)
V. A complete lesson plan – for a session, teaching ONE of the tasks
(includes all parts of a lesson plan)
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